In anatomy, a fascia is a band or sheet of connective tissue, primarily collagen, beneath the skin that attaches, stabilizes, encloses, and separates muscles and other internal organs. Fascia is classified by layer, as superficial fascia, deep fascia, and visceral or parietal fascia, or by its function and anatomical location. As with ligaments and tendons, fascia is made up of fibrous connective tissue containing closely packed bundles of collagen fibers oriented in a wavy pattern parallel to the direction of pull. Fascia is consequently flexible and able to resist great unidirectional tension forces until the wavy pattern of fibers has been straightened out by the pulling force.
Fasciae are normally thought of as passive structures that transmit mechanical tension generated by muscular activities or external forces throughout the body. The function of muscle fasciae is to reduce friction of muscular force. In doing so, fasciae provide a supportive and movable wrapping for nerves and blood vessels as they pass through and between muscles. Some fascial tissues are also able to store and release kinetic energy.
In recent years, advancements in understanding of fascial anatomy and physiology have provided a new theoretical framework for manipulation of this tissue subsystem of the body. Under this new framework, fascia are thought of as being multi laminar, mesh-like systems of soft tissue in which movement between layers is important to normal and healthy tissue function, as well as range of motion.
Changes in the density, stiffness and/or shearing ability of the fascial tissue can lead to maladaptive restrictions in the mechanical capacity of these tissues. These changes in turn can result in chronic pain and loss of function. When inflammatory fasciitis or trauma causes fibrosis and adhesions, fascial tissue fails to differentiate the adjacent structures effectively. This can happen after surgery where the fascia has been incised and healing includes a scar that traverses the surrounding structures.
Other conditions can also affect fascia. For example Dupuytren's contracture is a flexion contracture of the hand due to a palmar fibromatosis, in which the fingers bend towards the palm and cannot be fully extended. It is an inherited proliferative connective tissue disorder that involves the hand's palmar fascia. In patients with this condition, the palmar fascia thickens and shortens so that the tendons connected to the fingers cannot move freely.
It has been suggested that it is desirable to apply a sustained and repetitive shearing force on the skin of the person suffering the maladaptive fascial restrictions to mobilize the superficial and deep fascial tissues.
Mechanical devices designed for manipulation of patient tissue are known, including the Chiropractic Activator™ sold by Activator Methods International Ltd. of Phoenix Ariz.; the Torque Release Integrator™ (U.S. Pat. No. 5,632,765); and the Impulse iQ Adjusting Instrument™ sold by Neuromechanical Innovations of Chandler Ariz. However, the known such mechanical devices are intended for chiropractic manipulation for treatment of mechanical disorders of the musculoskeletal system, especially the spine, and are not configured for applying shearing force to the skin.